Tele-Doc

There are alot of things you don't get taught in medical school, things that would have been useful to know. One of those things is dealing with family members as patients. If I got any teaching in it at all it involved the words "don't do it". However, my family and friends base is primarily centered in the rural communities, and that has given me a different take on it all together. One of the things I never really empathized with was the comment that I'd heard espoused from so many doctors whom I respected, (insert rural community)..."could really use a good doctor". As I child I never felt medical care was lacking, that we were treated poorly because of where we were. When I was sick I drove to doctor that was 30 minutes away, hell some drive longer in the city to see a doctor where I work. What was this disparity that everybody I looked up to spoke of. Now I know. I remember the first time I really took the reigns of a patient that wasn't in my perview, my little brother. He lives 20 plus hours away from me. I in no way, shape, or form have a right to treat him medically, but I was forced to. He and my parents came to visit my family, one of the rare times they get to. During that time he got sick. I really didn't pay attention as to what his symptoms were at the time. For me when I'm a doctor, I'm a doctor, and when I'm me there is no part of me that is thinking medically, so I really didn't pay attention. But, I remember calling my mother a week or so later and he was still sick. The person who treated him gave him a 7 day course of augmentin and steroids. Talking on the phone, listening to what they gave him, I finally snapped. This was rediculous, he had at least been given the same treatment 6 or so times that year. I was at a crossroads, do I step in and figure out what is going on or do I continue to let my little brother get 'roided up while this doctor pockets his check. I stepped in. From that moment on I began taking more interest in my friends and family from a medical aspect and everytime I've added another case to bulster my underling reason for this, there is a huge deficit in rural medicine (especially in pediatrics). What I've come to understand is there are two types of doctors working in a rural practice. There is the excellent, intellegent doctor I'm happy to count in my ranks (he is there because he wants to be), and there is the doctor that hides there because he/she couldn't get a job anywhere else (the rural community is desperate for care and counts some care better than no care at all). Were I talking to an aspiring medical professional and they asked my advice, what I would recommend is this. If the friend or family member is willing, take a detailed history and if possible exam. Don't treat or test them if at all possible. Instead use your medical knowledge to search out an appropriate physician or specialist in there area that can see and treat them without bias. Do this and everyone will win. The patient in question gets the best care, you have no pressure to treat or guilt in treating (in certain instances), and the specialist gets good buisness as they should if their reputation has lead you to them. There are times I don't follow my own advice and will treat someone I know, however I would do this everytime if I could get away with it. It's a very important personal lesson to the new doctor, not only for yourself, but for the family and friends that will often suffer needlessly if you don't. Newbie-Doc